Health Links: Who Acts As a Source of Health Information In a Social Network?

Theoretical Background and research questions/hypothesis:  Members of a social network can influence the preventive health choices and cancer screening behaviors of other network members.  We sought to determine whether key network members act as sources and repositories of health information, and in what way such people might be unique in their personal characteristics and network connections. 

Methods:  We conducted in-person interviews with 438 insured community-dwelling adults ages 40-70 years in Massachusetts, Hawaii, and Georgia.  We gathered information on social networks andcommunication within these networks regarding routine health topics and cancer screening.  Participants reported whether family members and friends ask them for information or advice on health topics.  Characteristics of each respondent’s social network were explored, including number of people with whom the participant has discussed colorectal cancer (CRC) screening and number known to have completed CRC screening.  Participants were asked whether communication with social network members had ever led them to seek out or to avoid a cancer screening test.  We also conducted tests of health literacy for each participant using the REALM score.  

Results:  80% of respondents in our group described themselves as a source of health information or advice for others in their social network (89% of women vs. 68% of men, p<0.001).  Those who considered themselves information sources were more likely (94%) to have communicated with friends and family about CRC screening as compared to those who did not self-identify as sources (82%, p<0.05) and scored higher on tests of health literacy (mean REALM score 64.4 vs 63.1, p<0.05).   Health source respondents were no more likely to know someone who had undergone colonoscopy or sigmoidoscopy screening (90% vs 85%,p=0.05).  Respondents who self-identified as being a source of health information reported discussing CRC screening with more people in their social network (mean of 12.2 vs. 5.3 people) and knew more people who had undergone CRC screening via colonoscopy or sigmoidoscopy (6.1 vs 3.6 people).   Twenty-four percent of all respondents reported having scheduled a cancer screening test or mentioned a test to their doctor due to  communication with a friend or family member; 6% reported having avoided a cancer screening test due to such communication. 

Conclusions:  Nearly one-quarter of all respondents reported a screening decision that was influenced by friends and family. People who identified themselves as a source of health information within their social network were more likely to communicate with others about CRC screening. 

Implications for research and/or practice:  Further study is necessary to understand the roles played by key sources of health information within a social network.  These “health information ambassadors” may be effective targets for interventions aimed at promoting preventive screening and other healthy behavior.  Understanding the methods by which these key members of a social network disseminate and tailor their messages may also be valuable to healthcare researchers and policymakers.